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Year : 2020  |  Volume : 9  |  Issue : 2  |  Page : 68-73

Pediatric gallstone disease - Experience of two surgeons

1 Department of Pediatric Surgery, IMS and SUM Hospital, Bhubaneswar, Odisha, India
2 Department of General Surgery, VCSGGMS and RI (HNB Base Hospital), Pauri Garhwal, Uttarakhand, India
3 Executive Director, GRID Council (Generating Research Insights for Development), NCR, Delhi, India
4 Dental Surgeon/Consultant, Biostatistician, DPDOCC, Bareilly, Uttar Pradesh, India

Correspondence Address:
Dr. Keshri Amit
Department of General Surgery, VCSGGMS and RI (HNB Base Hospital), Srikot, Srinagar, Pauri Garhwal, Uttarakhand
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpai.jpai_5_20

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Introduction: Gallstone disease is being increasingly diagnosed as a cause of pediatric pain abdomen, requiring cholecystectomy. Most cases are idiopathic, while uncommon etiologic associations nowadays include obesity and hemolytic anemias/hemoglobinopathies; prolonged disease and high fat diet are predisposing factors. Management aspect is similar to adults. Aim: This study aims to compare the profile, interventions, and outcomes of pediatric gallstone disease patients, having undergone cholecystectomy, between two surgeons working at separate centers in India. Materials and Methods: Case records of all pediatric patients (≤15 years' age) having undergone cholecystectomy at both the centers by the respective surgeons (AP = 43 and KA = 17; total = 60 cases), between August 2015 and November 2019, were examined. Data were tabulated and inferences were drawn. Results: Male patients outnumbered female patients in both the studies (AP – M: F = 24:19, KA – M: F = 12:5). Anemia/hypoproteinemia and obesity were prevalent among the operated children (AP = 6 and KA = 3). Biliary pancreatitis (AP = 2 and KA = 2)/choledocholithiasis (AP = 7 and KA = 3) was the uncommon presentation; common bile duct obstruction with cholangitis/sepsis was rarer still. Laparoscopic cholecystectomy was the commonly performed procedure (AP lap: open = 41:2 and KA lap: open = 10:7). Choledocholithiasis patients underwent prior endoscopic retrograde cholangio-pancreatography (AP = 7 and KA = 3). Most patients had cholesterol/mixed gallstones. Complications were minimal, comparable with adult procedures. Conclusion: Pediatric gallstone disease is understated in literature and underestimated in clinical practice. Early diagnosis and timely referral to a surgeon for appropriate treatment can help prevent complications and reduce time–work–loss to child/parent.

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